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Research

Association between statin use and ischemic stroke or major hemorrhage in patients taking dabigatran for atrial fibrillation

Tony Antoniou, Erin M. Macdonald, Zhan Yao, Simon Hollands, Tara Gomes, Mina Tadrous, Muhammad M. Mamdani and David N. Juurlink; for the Canadian Drug Safety and Effectiveness Research Network
CMAJ January 09, 2017 189 (1) E4-E10; DOI: https://doi.org/10.1503/cmaj.160303
Tony Antoniou
Department of Family and Community Medicine (Antoniou), St. Michael’s Hospital and University of Toronto; Li Ka Shing Knowledge Institute (Gomes) and Li Ka Shing Centre for Healthcare Analytics Research and Training (Mamdani), St. Michael’s Hospital; Leslie Dan Faculty of Pharmacy (Gomes, Tadrous, Mamdani) and Department of Medicine (Juurlink), University of Toronto; Institute for Clinical Evaluative Sciences (Antoniou, Macdonald, Yao, Hollands, Gomes, Tadrous, Mamdani, Juurlink); Applied Health Research Centre (Tadrous), St. Michael’s Hospital; Sunnybrook Research Institute (Juurlink), Toronto, Ont.
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  • For correspondence: tantoniou@smh.ca
Erin M. Macdonald
Department of Family and Community Medicine (Antoniou), St. Michael’s Hospital and University of Toronto; Li Ka Shing Knowledge Institute (Gomes) and Li Ka Shing Centre for Healthcare Analytics Research and Training (Mamdani), St. Michael’s Hospital; Leslie Dan Faculty of Pharmacy (Gomes, Tadrous, Mamdani) and Department of Medicine (Juurlink), University of Toronto; Institute for Clinical Evaluative Sciences (Antoniou, Macdonald, Yao, Hollands, Gomes, Tadrous, Mamdani, Juurlink); Applied Health Research Centre (Tadrous), St. Michael’s Hospital; Sunnybrook Research Institute (Juurlink), Toronto, Ont.
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Zhan Yao
Department of Family and Community Medicine (Antoniou), St. Michael’s Hospital and University of Toronto; Li Ka Shing Knowledge Institute (Gomes) and Li Ka Shing Centre for Healthcare Analytics Research and Training (Mamdani), St. Michael’s Hospital; Leslie Dan Faculty of Pharmacy (Gomes, Tadrous, Mamdani) and Department of Medicine (Juurlink), University of Toronto; Institute for Clinical Evaluative Sciences (Antoniou, Macdonald, Yao, Hollands, Gomes, Tadrous, Mamdani, Juurlink); Applied Health Research Centre (Tadrous), St. Michael’s Hospital; Sunnybrook Research Institute (Juurlink), Toronto, Ont.
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Simon Hollands
Department of Family and Community Medicine (Antoniou), St. Michael’s Hospital and University of Toronto; Li Ka Shing Knowledge Institute (Gomes) and Li Ka Shing Centre for Healthcare Analytics Research and Training (Mamdani), St. Michael’s Hospital; Leslie Dan Faculty of Pharmacy (Gomes, Tadrous, Mamdani) and Department of Medicine (Juurlink), University of Toronto; Institute for Clinical Evaluative Sciences (Antoniou, Macdonald, Yao, Hollands, Gomes, Tadrous, Mamdani, Juurlink); Applied Health Research Centre (Tadrous), St. Michael’s Hospital; Sunnybrook Research Institute (Juurlink), Toronto, Ont.
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Tara Gomes
Department of Family and Community Medicine (Antoniou), St. Michael’s Hospital and University of Toronto; Li Ka Shing Knowledge Institute (Gomes) and Li Ka Shing Centre for Healthcare Analytics Research and Training (Mamdani), St. Michael’s Hospital; Leslie Dan Faculty of Pharmacy (Gomes, Tadrous, Mamdani) and Department of Medicine (Juurlink), University of Toronto; Institute for Clinical Evaluative Sciences (Antoniou, Macdonald, Yao, Hollands, Gomes, Tadrous, Mamdani, Juurlink); Applied Health Research Centre (Tadrous), St. Michael’s Hospital; Sunnybrook Research Institute (Juurlink), Toronto, Ont.
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Mina Tadrous
Department of Family and Community Medicine (Antoniou), St. Michael’s Hospital and University of Toronto; Li Ka Shing Knowledge Institute (Gomes) and Li Ka Shing Centre for Healthcare Analytics Research and Training (Mamdani), St. Michael’s Hospital; Leslie Dan Faculty of Pharmacy (Gomes, Tadrous, Mamdani) and Department of Medicine (Juurlink), University of Toronto; Institute for Clinical Evaluative Sciences (Antoniou, Macdonald, Yao, Hollands, Gomes, Tadrous, Mamdani, Juurlink); Applied Health Research Centre (Tadrous), St. Michael’s Hospital; Sunnybrook Research Institute (Juurlink), Toronto, Ont.
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Muhammad M. Mamdani
Department of Family and Community Medicine (Antoniou), St. Michael’s Hospital and University of Toronto; Li Ka Shing Knowledge Institute (Gomes) and Li Ka Shing Centre for Healthcare Analytics Research and Training (Mamdani), St. Michael’s Hospital; Leslie Dan Faculty of Pharmacy (Gomes, Tadrous, Mamdani) and Department of Medicine (Juurlink), University of Toronto; Institute for Clinical Evaluative Sciences (Antoniou, Macdonald, Yao, Hollands, Gomes, Tadrous, Mamdani, Juurlink); Applied Health Research Centre (Tadrous), St. Michael’s Hospital; Sunnybrook Research Institute (Juurlink), Toronto, Ont.
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David N. Juurlink
Department of Family and Community Medicine (Antoniou), St. Michael’s Hospital and University of Toronto; Li Ka Shing Knowledge Institute (Gomes) and Li Ka Shing Centre for Healthcare Analytics Research and Training (Mamdani), St. Michael’s Hospital; Leslie Dan Faculty of Pharmacy (Gomes, Tadrous, Mamdani) and Department of Medicine (Juurlink), University of Toronto; Institute for Clinical Evaluative Sciences (Antoniou, Macdonald, Yao, Hollands, Gomes, Tadrous, Mamdani, Juurlink); Applied Health Research Centre (Tadrous), St. Michael’s Hospital; Sunnybrook Research Institute (Juurlink), Toronto, Ont.
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    Figure 1:

    Study design. TIA = transient ischemic attack.

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    Table 1:

    Numbers of patients taking each statin, by diagnosis of ischemic stroke or transient ischemic attack, or major hemorrhage

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    Table 2:

    Characteristics of study patients

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    Table 3:

    Association between statin use and stroke or transient ischemic attack

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    Table 4:

    Association between statin use and major hemorrhage

    Table 4:
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Canadian Medical Association Journal: 189 (1)
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Vol. 189, Issue 1
9 Jan 2017
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Association between statin use and ischemic stroke or major hemorrhage in patients taking dabigatran for atrial fibrillation
Tony Antoniou, Erin M. Macdonald, Zhan Yao, Simon Hollands, Tara Gomes, Mina Tadrous, Muhammad M. Mamdani, David N. Juurlink
CMAJ Jan 2017, 189 (1) E4-E10; DOI: 10.1503/cmaj.160303

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Association between statin use and ischemic stroke or major hemorrhage in patients taking dabigatran for atrial fibrillation
Tony Antoniou, Erin M. Macdonald, Zhan Yao, Simon Hollands, Tara Gomes, Mina Tadrous, Muhammad M. Mamdani, David N. Juurlink
CMAJ Jan 2017, 189 (1) E4-E10; DOI: 10.1503/cmaj.160303
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